[Help for the medical decision. Logical method and application to thyroid pathology].
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Biomedical subjects
Publications and source records attributed to M Roux.
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Medical diagnosis assistance is described in terms of step by step logical reasoning methods. Boolean functions, possibly connected with phi-fuzzy functions, and a theorem proving algorithm may be used at each step. The choice merely depends on the accuracy of diagnosis at a given step. Numerical results based on a study of patients with thyroid diseases are presented.
During the hibernation period, the epiphyseal catecholamine charge is well detected in the garden dormouse; it appears more important in darkened animals at 22 degrees C and much less in animals under continuous lighting. Serotoninergic elements have only been shown in animals living under complete darkness. An important catecholaminergic and indolaminergic charge appears in sexually-hypoactive-animals; during ovarian activation after illumination a diminution (of this charge) is observed. In this species, an inverse relation exists between the importance of epiphyseal monoaminergic metabolism and the hypothalamic gonadostimulating catecholamine discharge.
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Among 1,645 biliary operation carried out between 1952 and 1974, the authors count 177 organic stenoses of the Oddi region. They recall the authenticity of chronic odditis, the pathological substratum of which is Oddi sclerodystrophy, a primary and progressive lesion. They emphasise the radiomanodebimetric criteria. The risk of an error of interpretation was 2% in this series. After discussing the etiopathogenesis and the physiopathological consequences of Oddi sclerodystrophy, they discuss the therapeutic choice between sphincterotomy and choledoco-duodenostomy. Temporary gall bladder drainage is only of interest in inflammatory labile manifestations without sclerodystrophy. The interest of diagnosis and initial surgical treatment of the lesion is that the classical post-cholecystectomy syndrome almost disappears.
The interaction of Mg2+ ions with adenyl-5'-yl imidodiphosphate, AMP-P(NH)P, has been studied at basic and acidic pH values by phosphorus magnetic resonance spectroscopy in aqueous solution. The results suggest that Mg2+ binds simultaneously to one (or both) of the two free oxygen atoms of the beta-phosphate moiety and to the nitrogen atom of the phosphate chain (P alpha-O-P beta-N-P gamma). The interaction arises from 1: 1 complexing of Mg2+ to AMP-P(NH)P. The mode of the Mg2+ binding on the phosphate chain remains the same at both basic and acidic pH values. As in the case of ATP and ADP, the association of Mg2+ reduces the pK by about 1.5 units. On the other hand phosphorus titration curves showed that when the phosphate chain does not possess the regular periodicity (O-P alpha-O-P beta-X-P gamma-O,X not equal to O) as in the case of ATP, protonation of the terminal phosphate group may induce a 31P chemical shift variation less important for this group than for the preceding one.
A survey of tolerance of a drug, determined in private practice under "naturalistic" conditions by 591 physicians, and involving 22277 patients is presented. The procedure used in private practice to gather systematic information about reactions to the drug involved a system of data sheets with detachable cards for optical reading and computer analysis. The survey was conducted under the responsiblity at regional level of a team of scientific coordinators-hospital pharmacologists and poison control centres. Possible side effects were noticed in 13,82% of patients, a figure similar to known nocebo reactions. Tolerance was significantly related to sex, age, weight, geographical area, duration of treatment, association with other durgs and therapeutic result. When related to individual physicians, the overall number of side effects and the frequency of three of them in particular did not follow a binomial distribution; the rate of adverse reactions was significantly related to the number of years of practice of the physicians.
The pinealocyte of the female garden dormouse presents ultrastructural characteristics correlated with the sexual cycle. In winter, during the period of sexual quiescence, the pinealocyte is very rich in liposomes, myelinic bodies and lysosomes; the same holds during the summer quiescence state. These organelles and a great number of intracellular vacuoles are very well developed in dormice artificially maintained in anoestrous during the normal sexual activity period by light deprivation. In spring liposomes are strongly reduced in animals that are awake and sexually active, whereas the number of "synaptic ribbons" and of densecored vesicles increases. This ultrastructural aspect can be obtained during winter quiescence in animals living at 22 degrees C, under continuous light, and showing early sexual activation. If illumination is prolonged over the seasonal sexual phase dilated cisterns of granular endoplasmic reticulum, filled with proteinaceous material, appear in the cell. It seems that light no more activates, but inhibits gonadostimulator mechanisms. The pinealocyte's ultrastructural elements which are characteristic of a definite sexual state generally develop before this state is fully established. Actually, the functional significance of these organelles is not known.
Hyphal walls of Aspergillus awamori containing increased amount of the alpha-glucan, nigeran, became correspondingly more opaque when viewed in the electron microscope as shadowed preparations. However, increased polymer deposition was not accompanied by any significant change in wall thickness. The nigeran of both A. awamori and Aspergillus niger occurred in situ in a crystalline conformation identical to that of single crystals prepared with pure polysaccharide. Furthermore, this polymer was the dominant crystalline material in the hyphae whether or not they were enriched in nigeran. Enzymic digestion of nigeran in A. niger and A. awamori revealed that the bulk of the polymer was exposed to the cell's exterior. However, a certain fraction was accessible to enzymic attack only after the wall was treated with boiling water. A third portion, detectable only by x-ray diffraction, was associated with other components and could not be extracted, even with prolonged boiling. It was removed by hot, dilute alkali and was associated in the wall with another glucan fraction. Dry heating of A. niger walls altered their susceptibility to enzymic digestion of nigeran in situ. It is proposed that this treatment introduces interstices in the crystal surface that facilitate attack.
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The authors report a few unusual cases of Crohn's disease of the colon and discuss the diagnostic problems which are raised in such cases. They then review the various colonic diseases liable to be considered in a differential diagnosis, and which may be linked to colonic Crohn's disease, e.g. ulcerative colitis, intestinal tuberculosis, carcinoma of the colon, colonic diverticulosis and sarcoidosis. In a chapter on treatment, they emphasize the favourable effect of acexamic acid and the necessity for very wide colonic resection, and they note a complication which they encountered during surgery for Crohn's disease: lymphatic peritonitis on the 8th day after right colectomy.
Alpha-MSH, beta-MSH and ACTH have been localized in the cells of hypophyseal intermediate lobe by fluorescence histoimmunological technics. Elaboration and excretion of these polypeptides are enhanced after dehydration or adrenalectomy. The most evident variations are seen with alpha-MSH and ACTH after dehydration, with beta-MSH after adrenalectomy.
The intraspecific growth of various endocranian organs (hypophysis, pineal gland and SFO) in the Rat compared to a group of Rodents shows that their allometry coefficient/somatic weight is : close to isometry for the anterior and intermediate lobes of the hypophysis which is suitable for endocrine glands; lower and close to that found for the relation brain weight/somatic weight for the nervous lobe in the Rat and in Rodents; and extremely low (0,33) for the SFO in the Rat, which is comparable to that found in Rodents (0,44). The allometry coefficient found for the pineal gland is not comparable to that found in Rodents (1,25). Many facts (important intra and interspecific variations, existence of species or individuals deprived of pineal gland) seem to indicate that this gland is not related to an essential somatic function.